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Anti-inflammatories shown to reduce spinal damage in patients with ankylosing spondylitis
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Anti-inflammatory pain relievers can slow the progression of ankylosing spondylitis, according to research presented at the American College of Rheumatology Annual Scientific Meeting in Chicago.
“These data provide further support for the idea that [non-steroidal anti-inflammatory drugs (NSAIDs)] might have not only a symptomatic efficacy by reducing pain and stiffness, but could be able to modify the course of the disease by slowing radiographic progression of the structural changes in the spine in patients with ankylosing spondylitis,” lead researcher Denis Poddubnyy, MD, PhD, stated in an American College of Rheumatology news release.
The team obtained cervical and lumbar spine X-rays of 164 patients from the German Spondyloarthritis Inception Cohort — 88 with ankylosing spondylitis and 76 with non-radiographic axial spondyloarthritis — at the beginning of the study and again after 2 years of follow-up, according to the release. The X-rays were reportedly reviewed and scored for structural changes such as erosions, sclerosis, vertebral squaring and syndesmophytes.
The researchers also made note of each patient’s use of NSAIDs at the beginning of the study, as well as every 6 months for the next 2 years. Dosage and duration were recorded, with high intake being defined in the study as an average intake of 50% or more of the maximal dose over 2 years and low intake being defined as an average intake of less than 50% of the maximal dose over 2 years.
Those patients with ankylosing spondylitis who demonstrated a high NSAID intake — around 27% of participants — had a significantly lower rate of spine disease progression than was found in those who had a low NSAID intake, which represented about 73% of participants.
The researchers noted, however, that they detected no differences based on NSAID intake in the group with non-radiographic axial spondyloarthritis. Still, according to the release, the findings remain significant — even when other factors that could affect the progression of ankylosing spondylitis and non-radiographic axial spondyloarthritis, such as the presence of syndesmophytes at the beginning of the study, were taken into account.
“The data indicate also that those patients who are at high risk for radiographic progression — eg, patients with ankylosing spondylitis who already have syndesmophytes — might especially benefit from the continuous use of NSAIDs,” Poddubnyy stated in the release. “Nonetheless, such a treatment should currently be justified by an increased level of pain and stiffness, and individual risk/benefit assessments must be performed in every patient.”
Reference:
- Poddubnyy D, Haibel H, Listing J, et al. Non-steroidal anti-inflammatory drugs reduce radiographic spinal progression in patients with ankylosing spondylitis ut not in non-radiographic axial spondyloarthritis. Paper 2486B. Presented at the 2011 American College of Rheumatology Annual Scientific Meeting. Nov. 4-9. Chicago.
